Organization
CIVITAS PARA VITA LIMITED LIABILITY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA SIOTIA BEATRICE HURDLE (OWNER)
(434) 917-1211
Entity
Organization
Contact information
Practice address
875 IRON BRIDGE RD, LAWRENCEVILLE, VA 23868-3937
(434) 917-1211
Mailing address
875 IRON BRIDGE RD, LAWRENCEVILLE, VA 23868-3937
(434) 917-1211
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/21/2024
Last updated
04/22/2025
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